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題名 | Upper Gastrointestinal Caustic Injury in Children=兒童上消化道腐蝕性傷害 |
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作者 | 周佳滿; 陳厚全; | 書刊名 | 臺灣外科醫學會雜誌 |
卷期 | 40:2 2007.03-04[民96.03-04] |
頁次 | 頁61-66 |
分類號 | 417.624 |
關鍵詞 | 上消化道; 食道; 兒童; Caustic injury; Esophageal strictures; Bougienage; Reconstruction; |
語文 | 英文(English) |
中文摘要 | 收集在本院治療之上消化道腐蝕性傷害病童資料,分析其預後並分享我們的經驗。從1983年6月至2005年10月,共收集89位(50個男孩,39個女孩)在本院治療之上消化道腐蝕性傷害病童臨床資料,包括初步之處理、手術方式、術後恢復及後續追蹤情形。發生食道狹窄而拒絕後續治療者予以排除。平均年齡2.87歲(範圍6個月大至13.2歲)。 74個病人(83%)係意外誤食鹼性腐蝕物,其他15個(17%)則是誤食酸性物質。48個病人沒有產生後遺症,39個發生食道狹窄,2個發生幽門前狹窄。平均追蹤時間為21.1個月(範圍2週至17.4年)。根據病人之最後臨床表現,分別執行單純食道擴張(21個病人,51.2%)、食道部分切除及吻合(3個,7.3%)、食道部分切除及吻合後續接受食到重建(2個,4.9%)、食道重建(13個,31.7%)及Billroth I手術(2個,4.9%)。目前36個病人(87.8%)沒有症狀,5個仍在接受間歇性的食道擴張術。在我們的上消化道腐蝕性傷害病童中,發生食道狹窄之後遺症者,不論接受食道擴張或食道重建都有良好之預後。 |
英文摘要 | We reviewed our experience and analyzed the outcome of upper gastrointestinal (UGI) caustic injury in children treated at our institute. Methods: From June 1983 to October 2005, a total of 89 children (50 boys and 39 girls) with caustic injuries treated at our institute were reviewed with medical records, including initial management, operative data, postoperative course and follow-up data. Patients with esophageal strictures who refused treatment were excluded. Mean age was 2.87 years old (ranging from 6 m/o to 13.2 y/o). Results: Seventy-four (83%) of them accidentally swallowed alkali corrosives, and the other 15 (17%) accidentally swallowed acid substances. Forty-eight patients had no sequelae, 39 patients had esophageal stricture and 2 had prepyloric obstruction. The mean follow-up period was 21.1 months (ranging from 2 weeks to 17.4 years). Esophageal bougienage alone (21 patients, 51.2%), segmental resection of the esophagus and anastomosis (3 patients, 7.3%), segmental resection of the esophagus and anastomosis with subsequent reconstruction of the esophagus (2 patients, 4.9%), reconstruction of the esophagus (13 patients, 31.7%) and Billroth I procedure (2 patients, 4.9%) were performed according to late clinical presentations. At present, 36 patients (87.8%) are free of symptoms, and 5 patients are still receiving periodic esophageal dilatation. Conclusion: In our patients with UGI caustic injury, those with sequelae of esophageal stricture had a good prognosis either by esophageal dilatation alone or esophageal reconstruction. |
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